Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.34 / $33.34 / $139.60	Facility		$33.34	$33.34	$139.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.17 / $26.30 / $33.34	Professional		$25.17	$26.30	$33.34
BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.57 / $39.70 / $69.72	Facility		$27.57	$39.70	$69.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $26.32 / $28.16	Professional		$25.00	$26.32	$28.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.32 / $36.84 / $84.22	Facility		$26.32	$36.84	$84.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $22.81 / $36.84 / $47.37	Professional		$22.81	$36.84	$47.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.30 / $40.06 / $53.69	Professional		$22.30	$40.06	$53.69
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $31.67 / $41.68 / $139.60	Facility		$31.67	$41.68	$139.60
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $25.72 / $40.59 / $48.18	Professional		$25.72	$40.59	$48.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.05 / $30.00 / $39.21	Professional		$29.05	$30.00	$39.21
United Facility/Professional Professional Modifier Low / Median / High Price $14.74 / $21.11 / $38.77	Professional		$14.74	$21.11	$38.77